DECLARATION

I, son/daughter of Mr/Mrs.
have applied for program at FIITJEE. I fully
understand that there are certain minimum eligibility criteria for this program and
my Admission / Enrolment remains conditional till the time I fulfil these criteria. I
assure that I shall be fulfilling the same. I hereby declare that I have appeared in the
Class X Board examination (Class for qualifying examination) in year 2020 under
Board.

I assure to produce/ send a copy of mark sheet / certificate of passing Class X Board
to FIITJEE for credential verification within 15 days of the declaration of Board
results. Also, I am certain that I shall comply with FIITJEE’s eligibility criteria for
admission in Distance Learning Program, failing which my candidature for this
program shall be forfeited and I shall have no claim on the Fee paid.

I also declare that the information given by me in the Enrolment form is true and
complete to the best of my knowledge and belief. If any of it is found to be incorrect
and if I fail to meet any of the pre requisites for admission as stated in FIITJEE’s
brochure, my admission shall be cancelled.

Date:
Place:

Signature of Parent / Guardian Signature of Student